Page 21 - Mobility Management, August/September 2020

swing away when it should have. Or maybe the tapered front end of an ultra- light is too tight for foot placement. So what happens is you do your spinal-cord type of transfer, but your foot doesn’t have room to rotate as your body does, and the next thing you know, you’ve got a spinal fracture of your tibia or some type of soft tissue damage at your knee because you turned, but it didn’t.”
Power Chair Transfers:
Powered Seating Is Key
The powered seating functions often
seen on CRT power chairs can facilitate transfers, Peterson said. “I think elevate, anterior tilt, and what we call anterior assist are all excellent ways to facilitate a standing transfer, whether it be indepen- dent, an assist to stand-pivot or a sit-to- stand. Sit-to-stand transfers are incredibly hard on not only the users, but also
the caregivers, whether those be family members, spouses, nurses or aides. When you elevate someone, what you’re trying to do is get those femurs and hips in a downhill orientation to let gravity assist
with the transfer. And possibly to use
the strength someone could have in their thigh muscles or in their legs to facilitate the transfer. So the ability to transfer from a different height is important.
“Anterior tilt can do that as well: You’re opening the hips as you’re lowering the feet. It’s almost like a seat lift chair: It’s lifting you out of the chair and pushing your backside forward. A lot of times people don’t need that full 45° of anterior tilt, hence some of the different degrees that you see from some manufacturers these days, which I think are beneficial. You’re moving someone forward as well as up, so you’re moving their reach forward.”
Additionally, power chair components can help with transfers to give clients extra support. “For some folks who still have the ability to do a little bit of a weight shift or to scoot to the edge of the seat, or for someone who has [a caregiver] to help them scoot to the edge of the seat, some- times just getting the footrest out of the way is a big idea as well,” Peterson said. “We get a lot of requests to power down
a foot platform to get that foot platform
or footplate on the ground so they can transfer without having anything in front of them or without having to clear some- thing, in terms of a front rigging.
“Then you start to look at all the ancil- lary parts of the chair. I’ve got someone forward, I’ve got their feet on the floor — now what are they pushing off of? How are they or someone else getting them to a standing position? We see all too often people who are pushing down on their swing-away joysticks. That joystick and that arm take a beating. So that’s why you have transfer handles and different types of armrests and surfaces to help with that reposition or that transfer.”
Perhaps one of the biggest potential advantages that powered seating offers is the ability to easily adjust a client’s seated height according to the transfer situation. “Downhill is usually a much easier way to transfer,” Peterson said. “Transferring from an elevated seat to a slightly lower bed is much easier. We’ve done systems in the past in which you have an elevated seat, and when it’s all the way down, the chair is lower than the bed, but when it’s
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MOBILITY MANAGEMENT | AUGUST-SEPTEMBER 2020 19 6/2/20 10:26 AM